International Journal of Audiology最新文献

Objective: To develop items and evaluate content validity of a new patient-reported outcome measure, Living with Cochlear Implants (LivCI), designed to assess personal and psychosocial factors relevant to adult cochlear implant (CI) users and candidates.

Design: The LivCI was developed following COSMIN best practice guidelines and involved extensive stakeholder engagement. Items (n = 87) were initially generated within five key themes: convenience and management, function and participation, stigma and identity, visibility and aesthetics, and psychosocial wellbeing.

Study sample: Content validity was assessed via cognitive interviews with CI users (n = 7) and candidates (n = 7), and an online survey of CI professionals (n = 15) that evaluated item relevance, clarity and theme fit.

Results: Lived experience participants found most items relevant and clear, with some revised or removed based on ambiguity or redundancy. Experts rated items highly (mean 3.6-3.9 out of 4), following removal of seven items and reclassification of several others. Readability scores met recommended standards for public-facing health measures. Further psychometric testing has reduced items and validated the LivCI.

Conclusions: Content validity with stakeholders was a key stage in the development of the LivCI. The LivCI was shown to assess personal and psychosocial factors relevant to adult CI users and candidates.

Objective: We aimed to establish how accurately the Parent-evaluated Listening and Understanding Measure (PLUM) identifies longer-term otitis media (OM)-related hearing status in young Aboriginal and Torres Strait Islander children.

Design: Retrospective review of clinical data, designed with Aboriginal, Torres Strait Islander, and non-Indigenous researchers and clinicians.

Study sample: De-identified audiological and demographic information gathered during 15,444 appointments with 6,716 Aboriginal and Torres Strait Islander children aged 7 years and younger.

Results: PLUM effectively distinguishes persistent, OM-related hearing loss requiring specialist referral (>30 dB HL better ear for >3 months) from transient and/or milder loss. Eighty-two percent of children meeting these referral criteria were "not yet on track", compared to 26% with comparable, but transient, loss. PLUM demonstrated strong performance: 82.4% sensitivity, 91.2% specificity, 98.6% negative predictive value, and 90.5% accuracy. Children "not yet on track" had 46 times higher odds of meeting hearing referral-level criteria (OR = 45.73, 95% CI: 12.60-165.93).

Conclusions: PLUM draws on parent/caregiver observations to help practitioners identify - or exclude - persistent OM-related hearing loss >30 dB HL, early in children's lives. A single assessment provides insight into longer-term hearing status, complementing point-in-time measures. This is the first accuracy evidence for a listening skills checklist using longer-term hearing as reference standard.

Objective: Recent research has proposed several behavioural measures as proxies for assessing communication difficulty caused by increased noise or compromised hearing. This study aimed to examine which of a selection of such measures best predicts perceived communication difficulty arising from noise or attenuated hearing.

Design: Dyad conversations, prompted by a spot-a-difference task, were recorded twice under four conditions: in quiet with and without occluded ears, and in noise at 60 and 70 dBA without occlusion. After each conversation, participants rated their perceived conversational success, effort, and frustration that were consolidated into a single score of perceived communication difficulty. Behavioural measures included measures of speech production, turn-taking, and gaze movement.

Study sample: Twenty-four older adults with normal hearing, forming 12 conversational pairs.

Results: Communication difficulty scores increased with increasing noise and attenuated hearing. Each behavioural measure was sensitive to changes in noise and/or hearing. Increased vocal level and gaze movement best predicted perceived communication difficulty under increased noise, whereas no robust model fitted the hearing condition data.

Conclusions: In noisy environments, perceived communication difficulty may be assessed through measures of speech production and gaze, while further research is needed to identify behavioural markers that reliably reflect difficulty resulting from compromised hearing.

Objective: To determine correlations between speech recognition thresholds (SRTs) for everyday sentences compared to Matrix sentences and digits-in-noise (DIN) triplets.

Design: Comparative analysis of SRTs across three speech materials in both cochlear implant (CI) users and typical hearing (TH) listeners, using linear regression and analysis of covariance.

Study sample: 18 experienced CI users (mean age 63 ± 5 years) and 18 age-equivalent TH listeners (mean age 62 ± 12 years), all naive to the test materials.

Results: SRTs of Matrix sentences and everyday sentences correlated significantly (R²: 0.81 for CI, 0.71 for TH), as did SRTs of DIN triplets and everyday sentences (R²: 0.42 for CI, 0.28 for TH). Regression slopes did not differ significantly between CI and TH groups in either comparison. However, intercepts differed significantly between the CI (-2.65) and TH (-6.70) groups for the DIN triplets, but not for the Matrix sentences. Slopes for the DIN triplets deviated significantly from unity for both groups.

Conclusions: Dutch/Flemish Matrix sentence SRTs closely correlate with everyday sentence SRTs for both CI users and TH listeners, establishing it as a reliable alternative for repeated assessment. DIN triplet SRTs showed weaker correlations with everyday sentences and with significant intercept differences between groups.

Objective: To characterize the association between Personal Attenuation Rating (PAR) and rates of significant threshold shift (STS). To determine whether pure-tone audiometric thresholds could reliably replace the unoccluded condition of the HPFT to improve test efficiency.

Design: Psychophysical hearing protector fit testing (HPFT) was performed without immediate training. Current and reference audiometric information was collected at the same appointment as HPFT. STS rates were compared to PAR using two complementary binning strategies to capture risk patterns. Agreement between standard PAR calculations and estimates using the pure-tone threshold in place of the unoccluded condition was examined using linear regression and Bland-Altman analyses.

Study sample: 1,829 military service members across two sites during routine hearing conservation appointments.

Results: Individuals with 0 dB PAR exhibited significantly elevated STS rates (17.9%; p = 0.001), representing double the sample average risk (7.7%). Linear regression demonstrated a strong correlation (R² = 0.85) between octave-band and pure-tone PAR calculations, suggesting 50% testing time reduction potential.

Conclusion: HPFT effectively identifies individuals at elevated risk for hearing loss, particularly those achieving minimal or no attenuation from HPDs. The substitution of pure-tone thresholds for the unoccluded condition is viable and could significantly improve testing efficiency in hearing conservation programs.

Objective: Exposure to loud noise can cause hearing loss and tinnitus. Few adolescents and young adults do, however, engage in hearing protective behaviours (HPBs) to reduce noise exposure. To enable the development of behavioural interventions, the present study aimed to identify influential, modifiable, psychological factors of HPB.

Design: An online survey measured predefined psychological factors and three HPBs (i.e. earplug use, safe listening, hearing protection at work). Psychological factors' univariate distributions and their associations with the HPBs were assessed to identify their potential as intervention target.

Study sample: Persons 12 to 25 years of age living in the Netherlands (N = 1637, mean age = 18.6, 67.6% female).

Results: Less than one in three participants wore earplugs at music venues, and less than one in two kept a safe level of sound exposure during use of headphones and speakers. Anticipated regret, awareness, experiential attitude, capacity and social norms were the psychological factors most strongly associated with HPBs (r ≈ 0.45 to r ≈ 0.65, and d ≈ 0.9 to d ≈ 1.5) that simultaneously, had univariate distributions indicating room for improvement.

Conclusions: Anticipated regret, awareness, experiential attitude, capacity and social norms are potentially promising intervention targets to increase HPBs in young persons.

Objective: To summarise the accuracy of otoacoustic emissions (OAE) testing relative to other methods used to screen for otitis media and related conditions in children.

Design: Systematic review and meta-analysis.

Study sample: Six databases were searched (Medline, CINAHL, Embase, PsychINFO, Scopus, and Web of Science) from inception to 2 November 2023, and included terms related to otitis media and otoacoustic emissions testing. The recommended JBI approach to critical appraisal, study selection and data synthesis was used.

Results: Of 3183 articles retrieved, nine articles met the inclusion criteria, with seven included in meta-analyses. Screening accuracy was calculated for transiently evoked OAE (TEOAE) vs. a combination audiological assessment (tympanometry, otoscopy, and audiometry) (pooled sensitivity = 67.6% (95%CI = 60.4%-74.1%); pooled specificity = 81.7% (95%CI = 75.3%-86.7%)); TEOAE vs. tympanometry (pooled sensitivity = 85.9% (95%CI = 50.4%-97.3%); pooled specificity = 90.4% (95%CI = 75.0%-96.7%)); and distortion product otoacoustic emissions (DPOAE) vs. tympanometry and otoscopy combined (pooled sensitivity = 54.8% (95%CI = 45.1%-64.2%); pooled specificity = 97.2% (95%CI = 43.8%-99.9%)).

Conclusions: Sensitivity and specificity were highest for TEOAE vs. tympanometry alone, suggesting TEOAE may be a relatively accurate option as a component of preliminary OM screening in children in primary health settings. These findings may be of interest to clinicians. However, due to few studies and considerable heterogeneity further research is warranted to confirm these results.

Registration: PROSPERO (CRD42021274917).

Objective: To describe the methodologies and results of qualitative studies examining cochlear implantation outcomes in adults with profound bilateral hearing impairment.

Design: Scoping review. Study sample: Studies with qualitative or mixed-method research designs published in indexed scientific journals on cochlear implantation outcomes in adults with profound bilateral pre-or postlingual hearing impairment and uni- or bilateral cochlear implant (CI). A comprehensive search of the PubMed, CINAHL, PsycInfo, Cochrane Library, SwePub, and DiVA databases revealed 855 records after duplicates were removed. After screening the titles and abstracts and reviewing full texts, 23 studies were included.

Results: Grounded theory (n = 10) and thematic analysis (n = 10) were the most frequently employed qualitative methodologies. Interviews were the predominant data collection method (n = 19), followed by surveys/questionnaires with open-ended questions (n = 10). Ten domains of cochlear implantation outcomes were identified: Improved hearing and communication, life-changing experiences, changes in personality and identity, benefits for the patient's social environment, employment-related experiences, cochlear implantation outcomes in prelingual profound deafness, music perception, tinnitus, negative experiences following cochlear implantation, and other cochlear implantation outcomes.

Conclusions: Qualitative research on cochlear implantation outcomes provides a nuanced understanding from the patient's perspective, capturing a broad range of benefits and challenges often overlooked in quantitative research.

Objective: To investigate the perspectives of professionals and adolescents on the impact of tinnitus during adolescence through qualitative focus group discussion and in-depth interviews.

Design: Qualitative descriptive study utilising thematic analysis with purposive sampling.

Study sample: Sixteen adolescents aged 10 to 17 years with bothersome tinnitus (duration of at least 3 months) and five healthcare professionals specialising in tinnitus management (with a minimum of 10 years of experience).

Results: Thematic analysis identified eight distinct themes that illustrate the comprehensive impact of tinnitus on adolescent functioning. Three common themes were identified from both stakeholder groups: (1) psychological and emotional distress, (2) Academic Performance and Learning Disruption, and (3) Sleep Architecture Disruption. Additionally, five themes emerged specifically from the adolescents' narratives: (4) Auditory Processing and Communication Challenges, (5) Concomitant Otological Symptoms, (6) Somatic Symptom Manifestations, (7) Executive Function and Attention Deficits, and (8) Maladaptive Cognitive Appraisals.

Conclusions: Tinnitus in adolescents is a complex condition that significantly affects psychological, cognitive, academic, and physical functioning. These findings highlight the necessity for suitable, interdisciplinary intervention strategies that address the various tinnitus-related challenges during this crucial developmental phase.